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$320M Medi-Cal settlement reached with HMO

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POSTED August 23, 2012 9:24 p.m.

LOS ANGELES (AP) — California and federal officials have announced a $320 million settlement over allegations a Long Beach-based health plan received overpayments from Medi-Cal, the state's Medicaid program.

U.S. attorney spokesman Thom Mrozek says SCAN Health Plan, a health maintenance organization, submitted payments on Aug. 10 to state and federal authorities to resolve an investigation. The settlement is the largest obtained from a Medi-Cal provider.

SCAN spokesman Alan Maltun says the HMO's voluntary repayment is intended to compensate for errors in the way the state set contract rates. No evidence of misconduct by SCAN was found.

Mrozek says Medi-Cal made overpayments because SCAN was reimbursed for long term-care patients who were cared for at home as if they were being cared for in nursing homes, where the costs are much higher.

 

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